D. The savings offset amount calculation is limited to the amount of funds necessary to provide subsidies pursuant to section 6912 and to support the Maine Quality Forum established in section 6951 and may not include general administrative expenses of Dirigo Health, except for general administrative expenses of the Maine Quality Forum.

The savings offset amount determined by the board in accordance with this subsection is the determining factor for inclusion of savings offset payments in premiums through rate setting review by the bureau.

Sec. 5. 24-A MRSA §6913, sub-§9, as enacted by PL 2003, c. 469, Pt. A, §8, is amended to read:

9. Demonstration of recovery of savings offset payments. As provided in sections 2736-C, 2808-B and 2839-B, the claims experience used to determine any filed premiums or rating formula may not reflect the savings offset payment amount determined in accordance with subsection 2, but must reasonably reflect, in accordance with accepted actuarial standards, known changes and offsets in recovery of savings offset payments by the carrier to health care providers in this State, including any reduction or avoidance of bad debt and charity care costs to health care providers in this State as a result of the operation of Dirigo Health and any increased enrollment due to an expansion in MaineCare eligibility occurring after June 30, 2004 as determined by the board consistent with subsection 1.

Emergency clause. In view of the emergency cited in the preamble, this Act takes effect when approved.

SUMMARY

This bill prohibits insurance carriers from including the costs of the savings offset payment used to support the Dirigo Health Program in health insurance premium rates.